高热惊厥复发因素及预后

目的：探讨高热惊厥的复发因素及预防后遗症。方法：对我院2000年和2001年收治的80例高热惊厥的患儿进行随访。结果：25例复发，复发率31．3％；复发因素与发作年龄、体温、惊厥时间有关，阳性家族史也有一定的影响；高热惊厥大多预后良好，少数因反复发作可转为癫痫。结论：加强健康教育，普及高热惊厥有关知识与适当预防性使用抗惊厥药物，可减少复发。     

Impaired renal function is associated with markers of endothelial dysfunction and increased inflammatory activity.

BACKGROUND: Patients with end-stage renal disease (ESRD) as well as those with mild renal insufficiency are at increased risk for the development of cardiovascular disease, which cannot be attributed entirely to traditional risk factors. Endothelial dysfunction and chronic inflammatory activity, two important phenomena in atherogenesis, can be found in ESRD. At present, it is unclear whether endothelial dysfunction and chronic inflammatory activity are related to renal function in the pre-dialysis stage. METHODS: In a cross-sectional, single-centre study, four groups of 20 subjects with renal function ranging from a normal, calculated creatinine clearance (>90 ml/min) to a pre-dialysis situation (<31 ml/min) were investigated. We measured markers of endothelial function [von Willebrand factor (vWf), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), tissue-type plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1) and E-selectin (ES)], and markers of inflammatory activity [secretory phospholipase A(2) (sPLA(2)) and C-reactive protein (CRP)]. Using these markers, composite endothelial function and inflammatory activity scores were constructed. RESULTS: Creatinine clearance correlated with the endothelial function score (r=-0.43, P<0.001), the inflammatory activity score (r=-0.53, P<0.05), vWf (r=-0.54, P<0.001), sVCAM-1 (r=-0.50, P<0.001), sPLA(2) (r=-0.28, P<0.05), homocysteine (r=-0.61, P<0.001), age (r=-0.54, P<0.001) and blood pressure (r=-0.44, P<0.001). In multivariate analyses, creatinine clearance was an independent determinant of the endothelial function score (beta=-0.34, P=0.006), plasma vWf (beta=-0.37, P=0.022) and sICAM-1 (beta=-0.33, P=0.012). The relationship of creatinine clearance with sVCAM-1 and endothelial function score was not significant when plasma homocysteine was added to the model. Creatinine clearance was also a determinant of the inflammatory activity score (beta=-0.31, P=0.025) and sPLA(2) (beta=-0.32, P=0.024), although this was no longer significant after correction for systolic blood pressure. CONCLUSIONS: Renal dysfunction is associated with markers of endothelial dysfunction and inflammatory activity. Plasma homocysteine may be an intermediate factor in the relationship between endothelial dysfunction and renal function, while blood pressure may modulate the association between inflammatory activity and renal function.     

特异性转移因子治疗银屑病的临床观察

本文介绍了用乙肝疫苗免疫猪,致敏后提取特异性转移因子治疗42例银屑病患者的临床观察。治疗的总有效率为92.86％,与对照组用双盲法进行对比分析,结果表明 TF-P 组显著高于对照组(P<0.01)。证明 TF-P 是一种较理想治疗银屑病的有效药物,无明显副作用。     

异体去细胞真皮基质重建真皮的实验研究

目的　通过不同形式去细胞真皮 (acellulardermalmatrix ,ADM )与单纯自体刃厚皮片移植的比较研究 ,探讨异体ADM作为真皮替代物的机制及效果。方法　猪全层皮肤缺损创面分别行颗粒状 (实验组 1)及网状异体ADM (实验组 2 )结合自体刃厚皮移植 ,以单纯自体刃厚皮移植作对照 ,观察各组移植术后皮片存活率、创面收缩率、组织学变化及血管化程度等。结果　移植术后 ,各组皮片均全部存活 ;与对照组相比 :两实验组创面收缩较小 ,弹性较好 ,创面充血程度轻 (P <0 .0 1) ,瘢痕增生程度也明显小于对照组。结论　网状及颗粒状异体ADM结合自体刃厚皮移植较好地封闭了全层皮肤缺损创面 ;其愈后功能优于单纯自体刃厚皮移植 ;颗粒状ADM制作简单 ,使用方便 ,值得进一步探索研究。     

18F-FDG SPECT显像纵隔病变病灶/本底比值测定方法研究

目的探讨^18F-脱氧葡萄糖(FDG)SPECT显像纵隔病变病灶，本底比值(L/B)的准确测定方法。方法对临床确诊的23例纵隔病变患者行胸部^18F-FDG SPECT显像，应用同机融合CT图像和三维定位技术，在相应^18F-FDG显像中依次选择气道区、脂肪区、间隙区、血管区和心脏区作为本底区，分别测定29处良、恶性病灶的L/B，并进行统计学分析。结果应用不同本底区测定的L/B对纵隔内良、恶性病变的诊断准确性不同。其中以血管区和间隙区作为本底区的诊断灵敏度(分别为82．4％和75．6％)和特异性(分别为83．3％和75．0％)较高。结论^18F-FDG SPECT显像同机融合CT图像和三维定位技术可为纵隔内病灶L/B的准确测定提供条件。     

边疆医学生心理健康状况调查

目的：了解边疆医学生的心理健康状况，为心理素质教育提供科学资料。方法：采用症状自评量表(SCL-90)对大理学院本科一年级、四年级，专科二年级普通班和成人班学生在期未考试前一周进行测查，用PEMS软件包比较分析各层次医学生的各项得分。结果：本科一年级学生总均分为0．9542，四年级学生为0．5903；专科二年级普通班学生总均分为0．7499，成人班学生为0．6560，各层次学生之间有显性差异(P＜0．05)。男生总均分为0．7863，女生为0．6968，男女之间无显性差异。各层次医学生SCL—90的10个因子分排序前三位的是：强迫症状、人际关系敏感或焦虑、抑郁。结论：随着大学教育的升级，学生的心理健康状况在提高，有必要采取不同方法对不同层次边疆医学生加强心理健康教育。     

Effectiveness of high-dose intravenous immunoglobulin in a case of acquired von Willebrand syndrome with chronic melena not responsive to desmopressin and factor VIII concentrate.

A patient with benign monoclonal IgG lambda paraproteinemia, acquired von Willebrand syndrome (AVWS), and chronic melena successfully responding to high-dose intravenous immunoglobulin (lvlg) is reported. Coagulation parameters at admission were APTT (ratio) 1.68; VIII:C 11 IU/dL; vWF:Ag 7 IU/dL:Ricof less than 3 IU/dl. RIPA was greater than 1.8 mg/ml, and bleeding time (BT) was prolonged (18 min). No evidence for an in vitro inhibitor against the VIII/vWF complex was observed. VIII/vWF measurements showed a short-lived increase after both DDAVP and Hemate P, and BT was transiently normalized. After intravenous Ig (1 g/kg for 2 days), VIII/vWF measurements, hemostatic parameters and multimeric pattern were completely corrected (VIII/C 106 IU/dl, vWF:Ag 168 IU/dl, RiCof 147 IU/dl, APTT ratio 0.89, BT 5'), with a return to pre-infusion values after 15 days. Hemoccult test became negative and packed red cell transfusions, of which 130 units were administered during the last year, were no longer required. After 18 months the patient is on maintenance treatment with repeated courses of Ig, at 3 to 4-week intervals based on VIII/vWF and BT monitoring.     

Extraction and Purification of Hepatocyte Growth Factor of New-Born Calf

新生小牛肝经组织匀浆、加热和离心制得粗制的肝细胞生长因子（ＨＧＦ），然后经过超滤、ＤＥＡＥＤＥ５２纤维层析，Ｓｕｐｅｒｏｓｅ１２凝胶过滤，ＭｏｎｏＱ离子交换层析和高效液相色谱进行分离提纯，用３Ｈ标记的胸腺嘧啶核苷掺入法在人肝瘤ＳＭＭＣ７２２１细胞株上检测提纯的新生小牛肝细胞生长因子的生物学活性，得到一分子量为（１２～１４）×１０３的有促进肝细胞有丝分裂的有效成分。显而易见此ＨＧＦ的分子量不同于循环在血浆中的ＨＧＦ的分子量。本文对２种ＨＧＦ的不同作用进行了讨论。